Plenary Speakers and Topics

Pat Wall Lecture - Plenary Session 1

Descending control of spinal nociception that originates within the brain and acts to modulate spinal transmission of nociceptive transmission is a major determinant of the acute and chronic pain experience. Investigations of these systems in basic scientific research is critical to developing therapeutic strategies for the relief of pain. Despite our best efforts, something is lost in translation and we need to question if we are employing the right approaches. It is these important issues that will be explored in this presentation.

Plenary Session 2

Professor Paul Eldridge
Neuromodulation; a review of the evidence and its clinical applications

“Neuromodulation” is best known for pain yet encompasses many other pathologies. Evidence for chronic neuropathic pain by spinal cord stimulation is established, but predates a number of technical advances – high frequency,
burst, whisper, high density. There is more peripheral nerve stimulation – the DRG, the occipital nerve and sphenopalatine ganglion. Other areas for pain are deep brain stimulation, and transcranial magnetic stimulation. Other
conditions with neuromodulatory solutions are epilepsy – deep brain and vagal nerve, and the latter may have other effects – use for rheumatoid arthritis, and depression. DBS is well evidenced for movement disorders but there is much further potential.

Plenary Session 3

Professor Richard Langford
What's new in acute pain?

Although acute pain management remains a challenge, multimodal therapy with various non-opioid adjuvants, local anaesthetic techniques and avoidance of parenteral routes have improved the patients’ pain experience. Enhanced recovery programmes after surgery are driving innovative strategies to eliminate ‘analgesia gaps’ (breakthrough pain), promote early mobilisation and to improve pain management plans and review after discharge from hospital.

Plenary Session 4

Dr Stephen Alexander
Barriers to the user of Cannabis and cannabinoids to treat pain

Cannabis sativa is one of the oldest cultivated plants with reported medicinal use in India and Egypt over 4000 years ago. In the modern era, Cannabis has been used for multiple indications, including pain, although the ‘real’ evidence for benefit is limited. The gap between anecdotal and scientific evidence derives from variables at multiple levels, including plant metabolite levels and doses; administration route; pharmacokinetics and patient profile. Recent changes in legislation, in the UK and elsewhere, regulating the availability of Cannabis derived medicinal products should prompt more systematic assessments of benefit (and potential harms) of these agents.

Plenary Session 5

Professor Nanna Finnerup
Neuropathic pain following cancer treatment

Neuropathic pain can be a long-lasting and debilitating complication to cancer treatments and is known to affect the quality of life in patients with cancer and in disease-free cancer survivors. Neuropathic pain is common
following surgeries with high risk of major nerve damage such as mastectomy, lymph node excision, and thoracotomy. Polyneuropathy is a common chronic complication to treatment with several types of chemotherapy. It is usually a length-dependent sensory polyneuropathy where symptoms have a “glove-andstocking” distribution and can be painful. Risk factors, diagnostic criteria and treatment of neuropathic pain following cancer treatment will be discussed.

Plenary Session 6

Professor Steven Linton
The role of social context in pain: why communication is central

Context matters. Indeed, it is a central, but missing link, in the biopsychosocial model where social aspects are often poorly understood. In this talk I will begin by defining social context and the idea of context sensitivity. Subsequently, I will review what we know about the impact of social context on pain perception. Finally, we will examine how social context might be harnessed to improve treatment in clinical situations. Since communication is a central factor in the social environment, I conclude with a simple method for improving communication which all practitioners may employ and benefit from.

Plenary Session 7

Oral presentations from the top six poster submissions

Plenary Session 8

Dr Benjamin Ellis
Analogue symptoms. Digital health

Clinical services are stretched as never before. The number of people living with disabling chronic pain is rising, but with no prospect of increased resources for health services. Whether it’s trying to do more with less, support people to improve their own health, or spot patterns in big data, some think that the answers are digital. So can technology save us, or is this all a mirage? This session will review current NHS digital health policy and practice, consider the current evidence and explore possible future trends.

BPS Lecture - Plenary Session 9

Professor David Bennett
How can we better stratify patients with neuropathic pain and what are the implications for treatment?

Neuropathic pain arises as a consequence of a lesion or disease of the sensory nervous system. It is increasingly common and difficult to treat. The last decade has seen significant advances in the methods we can use to stratify patients with neuropathic pain. We can generate classifications which are not just dependent on the aetiology of the injury but include sensory profile, physiological outcomes and genetics. Such stratification is improving diagnosis and ultimately will aid treatment selection for precision medicine.